A patient with a history of PUD is admitted with symptoms of gastric outlet obstruction. Which of the following is the most appropriate nursing intervention?

Correct Answer: B

Rationale: The correct answer is B. Gastric outlet obstruction requires immediate decompression to relieve pressure and prevent complications. Inserting a nasogastric tube allows for drainage of gastric contents and relieves the obstruction. Administering an antiemetic (Choice A) may provide temporary relief but does not address the underlying issue. Offering clear liquids (Choice C) can worsen the obstruction. Encouraging ambulation (Choice D) is not appropriate as the patient needs immediate intervention for the obstruction.

Correct Answer: B

Rationale: The correct answer is B: Osteoporosis. Long-term PPI use can lead to decreased calcium absorption, increasing the risk of osteoporosis. PPIs suppress stomach acid, which is essential for calcium absorption. Monitoring for bone density changes is crucial. A: Hypertension is not a common side effect of PPI use. PPIs do not directly affect blood pressure regulation. C: Hyperkalemia is not typically associated with PPI use. PPIs do not directly impact potassium levels. D: Anemia is not a common side effect of PPI use. PPIs do not directly cause decreased red blood cell production. In summary, monitoring for osteoporosis is important in patients on long-term PPI therapy due to potential calcium absorption issues.

Correct Answer: D

Rationale: The correct answer is D: CT scan of the abdomen. A CT scan is the most appropriate immediate diagnostic test for suspected perforated peptic ulcer disease (PUD). It provides detailed images to confirm the presence of perforation, assess extent of damage, and guide surgical intervention. Upper GI endoscopy (choice A) may delay diagnosis and treatment in a perforation scenario due to the risk of causing further injury. Abdominal X-ray (choice B) may show free air under the diaphragm, but CT scan is more sensitive and specific. Barium swallow (choice C) is contraindicated in suspected perforation as it can lead to barium leakage into the abdominal cavity, causing further complications.

Correct Answer: A

Rationale: The correct answer is A because peptic ulcer disease is primarily caused by the erosion of the gastrointestinal lining due to an imbalance between gastric acid and pepsin. Gastric acid and pepsin can damage the protective lining of the stomach and duodenum, leading to ulcer formation. This process is known as the acid-pepsin hypothesis. Choices B, C, and D are incorrect because they do not directly relate to the underlying cause of peptic ulcer disease. Inflammation of the esophagus due to acid reflux (choice B) is a characteristic of gastroesophageal reflux disease, not peptic ulcer disease. Overproduction of insulin leading to low blood glucose levels (choice C) is a characteristic of hypoglycemia, not peptic ulcer disease. Blockage of the pancreatic ducts leading to digestion of pancreatic tissue (choice D) is a characteristic of pancreatitis, not peptic ulcer disease.

Correct Answer: C

Rationale: The correct answer is C: Hydrogen potassium ATPase. This enzyme is not a hormone involved in the normal function of the gut. Gastrin, Secretin, and Cholecystokinin-pancreozymin (CCK-PZ) are all hormones that play important roles in regulating digestion and gut functions. Gastrin stimulates gastric acid secretion, Secretin regulates pancreatic and bile secretions, and CCK-PZ stimulates pancreatic enzyme secretion and gallbladder contraction. Therefore, C is the correct answer because Hydrogen potassium ATPase is not a hormone relevant to gut function.